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Patients should be charged for GP and hospital visits, leading doctors say.

The British Medical Association (BMA) will vote next week on whether to lobby the Government to introduce alternative ways to fund the NHS.

The radical move, which would end the principle of an NHS free at the point of delivery, will be discussed at the BMA's annual conference on Monday.

Those backing the proposal say charges are preferable to the "covert rationing" of healthcare which they say has become endemic.

And they said fees to see doctors would discourage people with minor ailments from clogging up GP surgeries.

A number of doctors have previously called for the introduction of a £25 fee to see GPs, but so far the BMA has not endorsed the policy.

Earlier this year polling of GPs found eight in 10 were in favour of charges for some services.

Mike Forster, lay secretary for Gloucestershire local medical committee (LMC) said the aim of the motion was to reduce pressure on the NHS, by encouraging patients to take more responsibility.

"There is an enormous amount of demand in general practice. We are just putting a shot across the bow saying is this something to be considered for ameliorating the deluge of patients going through general practice doors who might possibly think twice about doing it," he said.

Too many patients were visiting GPs when they would have recovered after a few days rest, or could have seen a pharmacist, he said.

Mr Forster said small fees might be enough to make patients think twice.

"Think about plastic bags," he said.

"A 5p charge on them has vastly reduced the number of plastic bags people use. It might be that a couple of pounds - £5 maximum – would make people think ‘should I spend that on the GP or should I nip down to the pharmacy where you can get the medication anyway.’"

Dr Dean Eggitt, chief executive of Doncaster LMC, also backed the idea of co-payments, saying the NHS should fund a more limited range of treatment, and patients who wanted more expected to pay "top up" fees.

The GP said the announcement by Theresa May of an extra £20bn a year by 2024 was not sufficient, suggesting it was like expecting Harrods to work on an "Aldi" budget.

“In reality, we either need to increase taxes dramatically, adopt a co-payment model - in effect cutting NHS services without a top up payment - or cut the quality and breath of NHS services for all - providing a service based upon need rather than want," he said.

The motion, proposed by Gloucestershire LMC for debate on Monday "calls on the BMA to encourage the Government to consider alternative means of funding the NHS" and says that "co-payments from patients should be considered."

A patient is given a vaccination by a doctor (stock image)Credit:
Rex

Similar motions are proposed by committees from Buckinghamshire, Scunthorpe and Worcestershire and Herefordshire, which said "denial of NHS healthcare is now so endemic, that it has become regrettably necessary to consider co-payments for NHS clinical services to re-establish adequate provision".

Cancer specialist Prof Karol Sikora said he was strongly in favour of co-payments, saying they encouraged people to take more responsibility for their health.

"Every other aspect of life you pay for - whether it’s your holiday, your home, your car or whether or not your children go to private school," he said.

Prof Sikora said the NHS should still provide a decent standard of care for free, with top-ups used to speed access for operations, GP appointments and expensive drugs.

"We have always talked about this but Governments of both left and right have avoided it because they thought they would lose votes. I don’t think they will," he said.

"They voted against the NHS at the start - they’re not all communists."

But Dr Richard Vautrey, chairman of the BMA's GP committee, said he did not believe most of the union's members would support the move.

"I would be very surprised if it is passed but the BMA is a democratic organisation and we will discuss the arguments," he said.

"This is an issue that has come up before and it is something we debate but the consensus has always been that the best way to fund the NHS is through general taxation.

"Clearly when there is a lack of investment as we have seen people are going to start looking round for alternatives," the GP added.

Rachel Power, chief executive of the Patients Association said charges were not the way forward.

"Funding the NHS through taxation spreads the risk of ill health across the population, and means that everyone can access care when they need it. "Charges, by contrast, would lead to well-off patients spending more on their care, and less well-off people being excluded, and suffering worse health as a result – it's both inequitable and inefficient," she said.

Earlier this month an Ipsos Mori poll of more than 1,000 adults found 71 per cent supported the idea of charges for missed GP and hospital appointments.

And 47 per cent backed "charging patients who have diseases and illnesses which are caused in some way by their lifestyle". In total, 47 per cent of those surveyed backed this, the poll commissioned by the NHS Confederation found. Both were more popular than increases in national insurance, which won support from 45 per cent of those polled, or increases in tax, which 42 per cent backed.

Professor Helen Stokes-Lampard, Chairman of the Royal College of GPs, said: “Charging patients for GP appointments would go against one of the founding principles of the NHS, that care is free at the point of need.

"It risks deterring patients from seeking medical help in the early stages of illness, when they can be dealt with cost-effectively and efficiently in primary care, rather than requiring expensive specialist care in hospitals, and it is bound to negatively affect our vulnerable patients, who are less able to pay for healthcare, most," she said.